I recently chronicled my journey through the physician state licensing process while using a licensing service for the first time. Although I am surrounded by acronyms in my daily work in physician staffing and credentialing, and throw them around conversationally, I realized I didn’t fully understand these entities intimately. What became more important than determining the value of using a licensing service was the need to unpack some of the everyday abbreviations and investigate how physicians need to interact with them during the licensing process. What follows is a practical resource for other physicians, based upon that experience.
1. FCVS
(Federation Credentials Verification Service)
Even in the earliest stages of my Pennsylvania state license application, FCVS surfaced multiple times. It showed up while filling out the web application for the licensing company I selected, and again during the pre-application process. One of the initial intake questions was: Do you have an FCVS login? I did, but I had to dust it off from 2017. Here is what I learned during my refresher.
What Exactly Is FCVS?
FCVS stands for Federation Credentials Verification Service. It’s operated by the Federation of State Medical Boards (yet another acronym, FSMB) and is a legitimate, centralized service designed to verify a physician’s core credentials. We’re talking about:
- Medical school transcripts
- Internship and residency graduations and diplomas
- Verification of identity through birth certificates and passports
- Occasionally, fellowship verification (if the fellowship was completed at the same facility as residency)
Is FCVS Required?
At last count, more than 10 states require physicians to use FCVS in order to apply for a license (Table 1), and the remaining states accept the FCVS verification.
| States that Require FCVS |
|
|---|---|
| Kentucky | New Hampshire |
| Louisiana | North Carolina |
| Maine | Ohio |
| Maryland | Rhode Island |
| Massachusetts | South Carolina |
| Nevada (Osteopathic applicants) | Wyoming |
Table 1: States that Require FCVS
If you’re an international medical graduate (FMG), using FCVS is unavoidable. That is because verifying foreign medical schools without FCVS is extraordinarily complex. So, whether you’re going for licensure in one of the states where it is required in or you’re an FMG, odds are you’ll encounter FCVS.
ILMIC?
Additionally, as the majority of states now utilize the Interstate Medical Licensure Compact (IMLC) to streamline the process of obtaining additional state licenses, physicians should be aware of which states participate in the compact pathway (Figure 1). Working through the ‘Compact’ can significantly reduce the administrative burden for those applying for state licenses in the participating regions.
Determining eligibility for the Compact is an important step in deciding on this path.
Figure 2: State (in navy) that serve as States of Principal Licensure
The Pros and Cons of FCVS
Pros:
- One-time primary source verification. Once your information is uploaded and verified, it’s stored and reusable (with a fee) for future license applications
- It also saves time in the long run. For physicians applying for multiple licenses, such as doctors like me practicing telehealth, or those traveling, or seeking locum tenens positions, FCVS can be a game-changer. Instead of submitting the same documents repeatedly, you verify them once through FCVS, and they’re ready for future use.
- In my case, the last time I accessed FCVS was eight years ago. However, when I recently started my Pennsylvania application, all my previous documents—medical school diploma, residency records, birth certificate—were still there, verified and ready to share with the State Board.
Cons:
- A quick note about fees. Yes, there’s a cost to use FCVS. Each time you share your credentials with another board, there are fees involved.
- A portfolio processing fee (currently 99 dollars), and then additional fees for the number of transcripts you are requesting to share (expect to pay an additional $70 for up to 5 transcripts).
- If you are an osteopathic applicant, expect additional costs for that transcript as well, whereas your allopathic counterparts have the USMLE transcript fee built into the FCVS transcript price.
Should You Use FCVS?
If you’re applying to multiple states, especially if you’re an FMG or working in telehealth, yes. FCVS streamlines what can otherwise be a painful process. It’s efficient, trusted, and recognized across state boards.
2. NPDB (National Practitioner Data Bank)
What Information Does a NPDB Query Provide?
- Malpractice payments
- Adverse actions and license restrictions
- Medicare/Medicaid exclusions
- Certain criminal convictions
What is an NPDB Self-Query?
But there are some exceptions. Approximately 10 states require the physician to order their own NPDB self-query, download the certified report, and submit it along with their application.
3. FBI
Fingerprint Background Checks – What Physicians Need to Know
Now, here’s what’s important: Only six states (and a few territories) don’t require FBI fingerprinting.
- Alaska
- Connecticut
- Hawaii
- Missouri
- New York
- Puerto Rico
- Rhode Island
- U.S. Virgin Islands
If you’re applying in those regions, you’ll still have to answer questions about your criminal history, but you won’t need to endure the hassle of fingerprinting. Everywhere else? FBI fingerprinting is required. Note that most states use the standard fingerprinting card but there are still a handful that use proprietary forms.
Is the FBI Background Check easy to get done?
Yes and no. The background check can be broken down into two parts: straightforward and annoying (Table 2).
Administrative Request
⦁ Simple to request online directly through the FBI
⦁ Affordable: 18-dollar fee
Fingerprinting
- Inconvenient and for some can be intimidating
- Deciding between USPS vs using 3rd party channelers is confusing
- Certain state boards partner with specific agencies
- Variable cost (50-80 dollar’s)
Table 2: Comparison of administrative and logistical factors involved in obtaining an FBI background check
What are the options for FBI Fingerprinting
Digital: Get it done electronically at participating USPS locations or a third-party approved channeler. Sometimes this is referred to as ‘virtual’ fingerprinting because your hand does not get soaked in ink, but you still need to go onsite to complete the procedure.
Breaking down Digital Options
USPS: The official electronic partner of the FBI to complete the fingerprinting process. Although not every post office can handle this, check online for locations and hours ( linked right from the FBI site)
Accurate Biometrics: accuratebiometrics.com
For the complete list of approved channelers, visit the FBI’s site. The bottom line is that whether you go through USPS, a third-party channeler, or your local police station, this fingerprinting step will test your patience, but it is a requirement in most states.
4. CME
| State | Initial Requirement | Time |
|---|---|---|
| Pennsylvania | 3-hour child abuse + 4 h pain/opioid training | Child abuse: before licensure; Pain training: within 12 months |
| Oregon | 6-hour pain management training | Within 12 months post license |
| New York | 2-hour child abuse reporting training | Initial licensure |
Table 3: States with Upfront or early CME requirements
Among these states, Pennsylvania has the most substantial CME requirements. For initial licensure, both MDs and DOs must complete:
- 3 hours of child abuse recognition and reporting (approved by the PA Department of Human Services) prior to initial licensure.
- 4 hours of opioid-related CME within 12 months post-licensure, which includes:
- 2 hours in practices of prescribing or dispensing opioids, and
- 2 hours in pain management or identification of addiction
Where Can Physicians Complete Pennsylvania’s CME Online?
Child Abuse Training
Pennsylvania maintains a list of approved vendors for child abuse recognition. For those in search of a user-friendly option with a progress tracker that is easy to start, stop, and resume, the University of Pittsburgh’s slide-based course is straightforward and can be completed in multiple sessions.
Opioid Training
The opioid CME requirement is somewhat longer and slightly more challenging to navigate, as many of the available offerings are either in-person or prescheduled webinars. For physicians, especially those applying for a license from out of state, neither option is ideal.
Online modules are available for self-study, free of charge, at Train-PA, but this requires a bit more effort on the part of the applicant as each module must be completed individually, and manually tracked to complete the requirements
For a more structured approach, the Pennsylvania Medical Society offers the required opioid training courses for $ 50 each (or free for members). This site is a little clunky in that you have to purchase the courses separately and check out twice. The easiest way to search the available courses is by linking to the online store directly. Completion of the prescribing opiates and identifying addiction courses fulfills Pennsylvania’s 4-hour requirement.
5. DEA
Chances are, as a physician, you have encountered the DEA acronym many times before—Drug Enforcement Agency. In this instance, DEA is an acronym of accompaniment because applying for a DEA registration, while unrelated, is closely tied to the licensing process, so they are frequently grouped together.
First take a moment to congratulate yourself on the license, that was no easy feat. But don’t stop there, as your journey is not over just yet. Check the requirements of the position you’re applying for, because most healthcare agencies and practices expect physicians also to have a DEA registration along with their medical state license because laws and bylaws require it – even sometimes when you won’t be prescribing controlled substances. There may even be a requirement for a state controlled dangerous substance certificate. If you got licensed in a CDS state, then that will be your next step.
Three Key Things to Know Before You Start Registering for a DEA
1. The DEA application is non-refundable and expensive. The current fee is $888 for a three-year registration.
2. Have your state license and expiration date ready for the application. If you apply for the DEA and your license is not active, you will forfeit the registration fee.
3. Know your employer’s information or practice address. You will be asked to provide a valid practicing address during the DEA application process.
Below is a step-by-step guide if you need it. The process is straightforward, and the DEA application is fairly quick. You can expect it to take about 10 minutes in total.
1. Head to the Diversion Control Division Website Click “New Registration” and follow the on-screen instructions.
2. Select Your Business
Activity Under the instruction list, select Form 224 > Practitioner You will see a preselected drop-down with a registration fee of $888. Click “Continue.”
3. Self-Attestation Notice
A pop-up will notify you about self-attestation related to addiction medicine. You will revisit this in one of the final steps of this process.
4. Enter Your Personal and Employer Information
This is where you will need to enter the business practice address in the state you are requesting the DEA.
5. Business Address, Phone, and Email
For the address, this is the site where you will be prescribing. For locum tenens work, it can be any healthcare facility with an address in the same state. We recommend using your personal cell phone and an email address you have easy access to. The DEA will use these fields as a way to contact the applicant and send confirmation emails. You will also be asked to validate this email address in a subsequent step.
6. Your Registered Mailing Address
Of note, this must match the state listed on your current medical license.
7. Add Your License and Schedule Details
Select the Controlled Substance Schedules you are applying for. It is advisable that you choose all available options, as many health systems, credentialing bodies, and staffing firms expect a DEA that covers all schedules (Table 1). This will avoid administrative flags or follow-up questions later.
Table 1: Recommended Schedules to Select During DEA Registration
Schedule 2 & 2n: High-potential for abuse (e.g., opioids, stimulants)
Schedule 3 & 3n: Less abuse potential (e.g., uprenorphine, testosterone products)
Schedule 4: Medications like benzodiazepines
Schedule 5: Lowest abuse risk (e.g., cough preparations with codeine)
8. Self-Attestation Reminder
You will be asked to confirm that you understand the responsibilities associated with prescribing medication for opioid use disorder. Confirm the statement when prompted.
9. Confirmation page
Make a note of your DEA Registration Number and Control Number. This number is now active and can be used for credentialing (and prescribing). This will also be available on the PDF receipt. You can use the zip code of the registered address along with your personal details, SSN, and DOB to check the status of the application online.
If you have any questions during the application, you can connect with Moonlighting Solutions or you may contact a DEA specialist.
